Individual
DR. BRIAN DEGENHARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
800 W JEFFERSON ST, KIRKSVILLE, MO 63501-1443
(660) 626-2304
(660) 626-2626
Mailing address
800 W JEFFERSON ST, KIRKSVILLE, MO 63501-1443
(660) 626-2304
(660) 626-2626
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
41887
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1700091782
—
MO
Enumeration date
05/11/2007
Last updated
08/16/2016
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